What do You Know about Vitamin E?

August 12, 2013What do You Know About Vitamin E? Reference:  Second International Symposium on Tocotrienols. April 2012 There has been a fair amount of publicity in the last year or two regarding Vitamin E as being a problem.  In particular, the HOPE studies showed the Vitamin E did not really help heart disease or cancer in almost 10,000 patients followed for 7 years in a randomized trial.  In fact, it appeared to cause more heart failure.  That was discouraging because there had been a lot of anticipation of the results. The basic science of Vitamin E and its congeners is pretty interesting, and the negative results were pretty discouraging. What happened? Here is the nugget of what “went wrong”.  The studies used alpha-tocopherol.  That is one of 8 vitamin Es.  Did you know there were 8 different Vitamin Es?  And that they come from two distinct families?  There are four in each family, apha, beta, gamma and delta.  The trienols are also Vitamin Es but act quite differently.  When we eat whole foods (nuts, grains, vegetables), we get combinations of them. When you do a study of just one, you get a marked imbalance and  lose the beneficial effect of the family. The research on Vitamin E – tocotrienols family, the “other” vitamin Es have been sparking imaginative research from around the world in the last 3 years.  In particular, the “trienol” family has sparked lots of interesting results.  For example, the gamma and delta forms of the tocotrienols have been shown to have the exact opposite effects of adhesion molecule in bench research models of atherosclerosis.  (Rabbits with heart disease).  The stuff given to humans for heart research, alpha tocopherol, makes trouble, whereas the gamma-delta tocotrienols do the exact opposite: they inhibit adhesion of white cells to blood vessel walls. Animal models also showed a 50% reduction in cholesterol levels with tocotrienols.  That’s pretty remarkable.  The mechanism for this is understood now in the down-regulation of the very beginning of the cholesterol pathway. The problem arises in our own bodies.  We actually have a bias towards absorbing alpha-tocopherol, and it inhibits the action and absorption of the gamma-delta tocotrienols.  Eating mixtures of Vitamin Es shows that when you have more than 25% alpha tocopherol, you don’t get any cholesterol lowering effect.  If you have less than 10%, you start getting stronger and stronger cholesterol and antiinflammatory effects. By itself, alpha tocopherol can be shown to increase cholesterol, increase the breakdown and metabolism of prescription medications, increase blood pressure and decrease bone mass.  These are all lousy, unwanted side effects.  How did we end up studying the alpha tocopherol form to the exclusion of all the others?  Heavens knows!  But it’s time to separate out the two from each other and begin to recognize that the complexity of our human diet and metabolism is far beyond what we first imagined. WWW. What will work for me?  I need to understand the gamma-delta family of the tocotrienols.  They sound like they have a lot of promise.  So, more next week.  For now, hold the skepticism about how awful Vitamin E might be and realize that we have several cousins in the family.  And not every one is a Black Sheep.   Pop Quiz 1.  Alpha tocopherol has been found to have serious negative side effects without much positive benefit in good randomized controlled trials with heart disease.  T or F Yup.  Disappointing but quite true.  And more heart failure to boot. 2.  The Vitamin E family has 8 members, four in each half with alpha, beta, gamma and delta members in each half?  T or F That's it.  8 cousins but not 8 brothers and sisters.  The Tocotrienols are quite different than the tocopherols. 3.   Alpha tocopherol is absorbed preferentially, and it appears to block some of the beneficial effects of the trienols.  T or F That's it.  That may be the reason we have such conflicting scientific research studies. 4.   Alpha tocopherol actually increases cholesterol?  T or F True 5.   If I am taking Vitamin E, I probably should look at the bottle, and if it's alpha-tocopherol only, I should stop.  T or F Perfect.  Please stop now.